Locations:
A reverse shoulder replacement is an alternative to traditional shoulder replacement surgery. It’s a good option for people who need a shoulder replacement to treat severe pain and other symptoms and who also have other issues (like a severely torn rotator cuff) that make having a typical replacement impossible.
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Reverse shoulder replacement is surgery to replace your shoulder joint. It’s a type of arthroplasty (joint replacement). Healthcare providers sometimes call it a reverse total shoulder arthroplasty.
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A surgeon will remove your natural shoulder joint and replace it with an artificial joint (a prosthesis) made of metal and plastic.
Your shoulder is where your shoulder blade (scapula) connects to your upper arm bone (humerus). The top (head) of your humerus is shaped like a ball. It fits into the socket in your scapula (glenoid).
Reverse shoulder replacement gets its name from how the prosthetic joint fits into your shoulder. Your surgeon will flip-flop the usual place of the ball and socket. After surgery, the ball will stick out from your scapula and fit into a socket at the top of your humerus (the reverse of the usual alignment).
Reverse shoulder replacement treats the same conditions as traditional shoulder replacement. Your healthcare provider may suggest either one if you have severe shoulder pain or can’t move your shoulder well (limited mobility). They’ll usually suggest surgery if other, nonsurgical treatments haven’t been able to manage symptoms.
Shoulder arthritis is the most common condition that causes people to need a shoulder replacement. Your provider will recommend a reverse shoulder replacement if you also have another injury or issue that would make a traditional shoulder replacement impossible or unlikely to work well, including:
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These types of issues can affect your bones, muscles or connective tissue (tendons and ligaments) so much that they won’t support a traditional shoulder replacement. Reversing the position of the ball and socket in your shoulder joint lets your surgeon restructure your joint in a way that helps prevent complications. It’ll also give your joint more stability and let you regain as much of your shoulder strength and mobility as possible.
Your healthcare provider or surgeon will help you get ready for surgery. You might need:
Tell your provider and surgeon about any medications and over-the-counter supplements you take. You may have to stop taking them before your surgery.
Your surgeon will tell you when you should stop eating and drinking the day before your surgery. Most people need to avoid eating and drinking for eight hours before their surgery. Your surgeon will tell you which medications are safe to take with a sip of water the morning of your surgery.
The day of your surgery, you’ll receive anesthesia to numb your body and make sure you don’t feel any pain. An anesthesiologist will give you either general anesthesia to put you to sleep, a regional anesthesia to numb the area around your shoulder or a combination of both. They may give you other medications to make you sleep if you need regional anesthesia.
During a reverse shoulder replacement, your surgeon will:
Reverse shoulder replacement surgery usually takes an hour or two. It may take more or less time depending on how damaged your shoulder joint and the muscles and connective tissue around it are.
Reverse shoulder replacement can dramatically reduce the pain and stiffness you feel in your shoulder. Many people are able to use their shoulders better or more effectively than they were before surgery (they have increased mobility).
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Reverse shoulder replacement also gives people who aren’t good candidates for traditional shoulder replacement an option to relieve severe pain and other symptoms.
Reverse shoulder replacement shares the same risks as any type of surgery. Rare complications include:
Your surgery care team will move you to a recovery room after your surgery. They’ll keep an eye on your vital signs and pain level while you recover from the anesthesia.
Some reverse shoulder replacements are outpatient procedures (you can go home the same day). Your surgery may be inpatient, which means you’ll need to stay in the hospital at least overnight. Your care team will tell you when it’s safe for you to go home.
It usually takes around six months to recover completely after a reverse shoulder replacement. You’ll need to keep your arm in a sling for a few weeks right after surgery. After that, your surgeon may give you exercises or shoulder movements to help you slowly start using your shoulder again.
Your surgeon will suggest a combination of prescription pain medication, over-the-counter NSAIDs (if it’s safe for you to take them) and acetaminophen to relieve your pain. Your surgeon will tell you how much of each kind of medication you can take each day or in a certain amount of time.
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After a few weeks, you’ll need physical therapy. A physical therapist will give you stretches and exercises to help you strengthen your shoulder muscles and regain your range of motion (how far you can move your shoulder).
You may need to avoid intense physical activity like working out, playing sports or lifting heavy objects for a few months. You can gradually increase your activity level once your surgeon says it’s safe.
A reverse shoulder replacement usually lasts a long time. The implants almost always last for at least 15 years. Many people who have reverse shoulder replacement live with the prosthetic for the rest of their lives.
Most people who have a reverse shoulder replacement can lift their arm above their shoulder height, but not always completely above their head. For example, you’ll be able to lift your arm to the level of your neck (or slightly higher), but might not be able to lift it all the way up to cover your ear with your upper arm.
Your surgeon might suggest a limit on how much weight you can lift with your shoulder. This might be a temporary restriction. But you might also need this limitation permanently to avoid putting too much stress on your shoulder muscles.
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Call your surgeon or healthcare provider right away if you experience any of the following symptoms after surgery:
Reverse shoulder replacement doesn’t mean your surgeon will perform your operation with their gown and mask on backward. It’s a safe, effective way to do shoulder replacements for people who have severely torn rotator cuffs or other severe damage that means they can’t have traditional shoulder replacements.
You might have some limitations on your shoulder, even after you recover, but you should be able to move and use your shoulder for all your everyday activities. For most people, the benefits of reduced pain and other symptoms outweigh the downside of putting slightly less stress on that shoulder.
Last reviewed on 01/29/2025.
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